John Raymond Cormier III, AP, RN

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

3926 Issued in FL

Practice address

1009 SW Main Blvd Ste 110
Lake City, FL 32025-5784

Phone

(386) 628-1088

NPI assigned

Mar 17, 2018

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Serenity Alternative Healthcare & Acupuncture Center

  • Clinic/Center
  • Lake City, FL
  • NPI 1568966414
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1521244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1407359276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "595 SW INFINITY PL",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320245378",
            "telephone_number": "386-628-1088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 SW MAIN BLVD STE 110",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320255784",
            "telephone_number": "386-628-1088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORMIER",
        "first_name": "JOHN",
        "middle_name": "RAYMOND",
        "name_suffix": "III",
        "credential": "AP, RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-17",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "FL",
            "license": "3390372",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "FL",
            "license": "3926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Acupuncturist in Lake City, FL
• Providers in Lake City, FL by specialty
• Acupuncturist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.